Biophysical Modeling to Determine the Optimization of Left Ventricular Pacing Site and AV/VV Delays in the Acute and Chronic Phase of Cardiac Resynchronization Therapy.
Device Optimization for Acute and Chronic CRT Background Cardiac anatomy and function adapt in response to chronic cardiac resynchronization therapy (CRT). The effects of these changes on the optimal left ventricle (LV) lead location and timing delay settings have yet to be fully explored. Objective...
| Published in: | Journal of Cardiovascular Electrophysiology Vol. 28; no. 2; pp. 208 - 216 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | equations & formulas research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Feb2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121236294&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121236294 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Feb2017 vid: 28 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 121236294 121236294 121236294 10.1111/jce.13134 121236294 ppf: 208 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Biophysical Modeling to Determine the Optimization of Left Ventricular Pacing Site and AV/VV Delays in the Acute and Chronic Phase of Cardiac Resynchronization Therapy. aug: au: LEE, ANGELA W. C. CROZIER, ANDREW HYDE, EOIN R. LAMATA, PABLO TRUONG, MICHAEL SOHAL, MANAV JACKSON, THOMAS BEHAR, JONATHAN M. CLARIDGE, SIMON SHETTY, ANOOP SAMMUT, EVA PLANK, GERNOT RINALDI, CHRISTOPHER ALDO NIEDERER, STEVEN affil: Division of Imaging Sciences and Biomedical Engineering, King's College London, London UK sug: subj: Biophysics Evaluation Heart Ventricle Physiology Cardiac Resynchronization Therapy Bundle-Branch Block Heart Hemodynamics Human Heart Failure Male Middle Age Aged Middle Aged: 45-64 years Aged: 65+ years Male ab: Device Optimization for Acute and Chronic CRT Background Cardiac anatomy and function adapt in response to chronic cardiac resynchronization therapy (CRT). The effects of these changes on the optimal left ventricle (LV) lead location and timing delay settings have yet to be fully explored. Objective To predict the effects of chronic CRT on the optimal LV lead location and device timing settings over time. Methods Biophysical computational cardiac models were generated for 3 patients, immediately post-implant (ACUTE) and after at least 6 months of CRT (CHRONIC). Optimal LV pacing area and device settings were predicted by pacing the ACUTE and CHRONIC models across the LV epicardium (49 sites each) with a range of 9 pacing settings and simulating the acute hemodynamic response (AHR) of the heart. Results There were statistically significant differences between the distribution of the AHR in the ACUTE and CHRONIC models (P < 0.0005 in all cases). The site delivering the maximal AHR shifted location between the ACUTE and CHRONIC models but provided a negligible improvement (<2%). The majority of the acute optimal LV pacing regions (76-100%) and device settings (76-91%) remained optimal chronically. Conclusion Optimization of the LV pacing location and device settings were important at the time of implant, with a reduced benefit over time, where the majority of the acute optimal LV pacing region and device settings remained optimal with chronic CRT. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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